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Home My WebLink AboutHomestead_Rose (4) STATE FORM 73169(RI 1749) - TREASURER FORM Ts-IA APPROVED BY STATE BOARD Of ACCOUNTS,2119 PRFSIXB3m BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE C 6.1.1'22-LI IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead I fraud causes higher tax bills for all; therefore, HEA 1344-2009 requires taxpayer� r eiv e homestead standard deduction to verify that they are eligible to receive the benet#tar t , additional indentifying information necessary to allow county government to better monj � m ;tad filings. This information will be kept confidential and can only be accessed by_authorized/e n o als. The Department of Local Government Finance will use this information to create tools at,wi h county officials eliminate homestead fraud. PART I: PROPERTY INFORMATION Property Address(number and street,city,state,and ZIP code) ( atg . • ip S, P a Li767D State Parcel Number 1 86 - ii - za- a03- 000. gga-oax PART 2:TAXPAYER INFORMATION Owner I y First Middle Last 6��k.!-�, V ciu is n ear Mailing Address(number and street,city,state,and ZIP code) n Same as property address i gads a 7-1 -1 670 Spouse First Middle Last Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address 1 I Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below) Stale PART 3:CERTIFICATION Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is Ieligible to receive the homestead standard deduction on this property.Each undersigned also understands that,by claiming additional homestead deductions unlawfully,he or she may be liable for back taxes and substantial financial penalties. Owner I Signature Date ■ , lAa '!-�'�" APR 8 2015 r a . �� . A DITOR i .i INSTRUCTIONS — -- — — — -i